FALLS CHURCH, Virginia (NNS) -- Before news broke about the contagion aboard USS Theodore Roosevelt, a two-person team from Naval Medical Preventive Medicine Unit (NEPMU) No. 5 was already onboard supporting surveillance of novel coronavirus.
When the first case of COVID-19 was suspected aboard USS Kidd, an environmental health officer (EHO) from NEPMU-5 was in constant communication with the ship’s independent duty corpsman (IDC), providing updated guidance and protocols to support shipboard contact tracing and sanitation procedures.
Other members of NEPMU-5 were among a contingent of medical personnel from multiple units to screen the disembarking Sailors when the ship arrived at San Diego.
Although the COVID-19 pandemic has posed new challenges for the Navy, and nothing in recent memory may quite compare to its devastation, in many respects San Diego’s NEPMU-5 was tailor-made for this fight.
One of the Navy’s original preventive medicine units, NEPMU-5 was born in March 1949, when the Navy consolidated the duties of World War II-era epidemiology teams into specialized units at Norfolk, Virginia; Camp Lejeune, North Carolina; Great Lakes, Illinois; San Diego; and Pearl Harbor (then in the Territory of Hawaii).
Their original mission was to investigate disease outbreaks stateside and overseas; conduct sanitary inspections and surveys of disease vectors; and oversee the sanitary control of food, water, waste disposal and living quarters throughout the Navy and Marine Corps.
Today NEPMU-5 is one of four remaining units, in Norfolk (No. 2), Pearl Harbor (No. 6), and Rota, Spain (No. 7) under the command of the U.S. Navy and Marine Corps Public Health Center (NMCPHC) in Norfolk.
“I always like to view us as a small CDC (Centers for Disease Control and Prevention),” said Capt. Peter Obenauer, officer in charge of NEPMU-5 since 2018.
Among the 85 members of Obenauer’s unit are preventive medicine officers, environmental health officers, industrial hygiene officers, entomologists, microbiologists, preventive medicine technicians and laboratory technicians and an audiologist. Combined, this small but robust team provides frontline support and guidance to the fleet, the U.S. Marine Corps, and shore establishments.
As an operational unit, NEPMU-5’s mission success is built on the relationships with the fleet and shore units. “We provide boots on the ground for shore and fleet units to support disease outbreaks, we have an established relationship that facilitates communication and coordination,” said Cmdr. Gary Brice, NEPMU-5’s assistant officer in charge. “And we provide the support, guidance and the expertise that allows organic units to handle routine types of disease outbreaks in an efficient and timely manner.”
Before the pandemic, NEPMU-5 was heavily involved with nonstop shipboard investigations into tuberculosis, parotitis and diarrheal disease outbreaks. The unit was also actively monitoring news of an acute respiratory syndrome first reported in Wuhan, China, in 2019.
By mid-January 2020, NEPMU-5 began notifying Third Fleet as well as several Type Command (TYCOM) surgeons about their concerns. “We monitor these outbreaks globally, because we recognize that deployed military personnel may be exposed to new emerging pathogens such as COVID-19, and locally endemic pathogens to which they may lack immunity,” said Brice.
Among NEPMU-5 initial efforts was coordinating with the Armed Forces Health Surveillance Branch (ADHSB) as well as the CDC to try to get more information for the Navy. Soon after, NEPMU 5’s parent command tasked several deployable preventive medicine teams to support the Cobra Gold Exercise in Thailand.
Collectively, the individual NEPMUs sent forward deployed teams to USS America, USS Blue Ridge and USS Teddy Roosevelt where they brought laboratory capabilities to detect COVID and other diseases.
As COVID-19 began taking a toll on Italy, NEPMU-5 deployed Environmental Health Officers to Naples and Sigonella to operate as Public Health Emergency Officers. When the hospital USNS Mercy sailed into Los Angeles to serve as a “relief valve” for the overburdened health care system, an occupational medicine physician, a microbiologist, an environmental health officer, multiple preventive medicine technicians and a laboratory tech from NEPMU-5 were on board.
The need for public health specialists in the Navy is not without some burdens for the unit’s leadership, however.
“At one time, just within the time period of the last six months we had almost 15 people deployed out of here, which puts a tremendous amount of stress not only on the individuals here, but our mission in San Diego,” Obenauer said. “So trying to push people out the door to support those ships puts additional challenges on folks back here to compensate for their departure.”
It is the dedication to the mission and resilience Obenauer is most proud of, noting that some members of his team volunteered for redeployment within 48 hours of returning from their original deployments.
One of the more well-known NEPMU-5 interventions in the pandemic was its support of the USS Kidd outbreak in April. Lt. Dawn Whiting, EHO with NEPMU-5, was in early communication with the destroyer’s IDC when he first suspected a sailor’s GI symptoms as being coronavirus.
She provided him with NEPMU-5’s newly developed toolkit that included the latest COVID guidance for ships underway, worksheets for contract tracing, and mitigation measures. This information would ultimately lead to the deployment of Naval Hospital Jacksonville’s Rapid Response Team to Kidd and the medical evacuation of Sailors to USS Makin Island.
When Kidd arrived at San Diego on April 28th, NEPMU-5 was pierside processing the Sailors disembarking the ship. As Brice explained, “I think it took us about six hours to go through the whole iteration, but we collected swabs on all the Sailors including those who rode back aboard Kidd. And we also conducted a serological screening for antibodies.”
The screening was done in partnership with the Medical Readiness Division and Naval Health Research Center (NHRC) and, in many respects is reflective of the ongoing collaborative efforts key to NEPMU-5’s mission success.
Obenauer added: “I think one of the lessons learned during this pandemic was having strong established relationships with the fleet and shore units is critical. No one can do it on their own, it’s a huge team effort.”
And whether working with fellow preventive medicine units, with Medical Treatment Facilities (MTFs), Third Fleet, Commander, Submarine Force, U.S. Pacific Fleet (SUBPAC), Commander, Naval Surface Force Pacific (SURFPAC), Commander Naval Air Force, U.S. Pacific Fleet (AIRPAC), Military Sealift Command (MSC), medical laboratories, or with other federal agencies like CDC, NEPMU-5 credits these relationships as the root of its effectiveness during this pandemic.
“It’s definitely not just us,” said Brice. “Keep in mind this is almost like a symphony and everybody’s doing their part in this fight. And when you’re in synch, you’re making great music.”
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